Wednesday, May 02, 2007

I try not to think too much about medical malpractice because it leaves me curled up in the fetal position sucking my thumb for hours, but PandaBearMD had a totally over the top but hilarious look at the future of medicine, where doctors become pariahs, hospitals are burnt down, and lawyers get to wear white coats and become the most important purveyors of healthcare. Like I said, it's totally over the top, but there were some parts that made me laugh out loud. Check it out:
They had a trial of course, but he wasn’t exactly a model citizen and at that time lot of people still remembered how those doctors with their fancy medical education and their big fancy doctor words used to rub it in our faces that they knew more about our health than we did. The jury delivered a guilty verdict pretty quickly after he was hanged.
After selecting our court-appointed malpractice attorney, we went inside and ‘presented’…that’s genuine doctor talk kids and I’d better not hear you saying it in public… we presented ourselves to the young lady sitting at the counter. Waiting for medical service was technically against the law but it was unavoidable, seeing as our attorney had to inspect all of the hospital’s certifications. Sometimes they tried for a settlement right away and it was not uncommon to walk out of there with a couple of thousand bucks.
Against my attorney’s advice I waived my HIPAA rights so the doctor didn’t have to wear a blindfold and examine me in a darkened room through a one-way mirror.

My attorney was magnificent. He consulted with me at length before letting me answer any questions and I plead the fifth quite a few times on his advice, especially when it came to my past medical and travel history which he felt was irrelevant. Clearly, as my lawyer stated, the doctor was badgering the patient.

I told him I needed some antibiotics. He told me I had appendiwhatsities or something like that. And then the magic was gone and I saw that he was just another arrogant relic of the bad old days before they caught on that the customer was always right. We got a court order from a the vending machine back in the waiting room and I made the doctor write my prescription for antibiotics in Klingon just to show him who was in charge.
It's a funny if somewhat depressing read but I don't think such a future is a reality, because I can't think of a single lawyer who can deliver a baby or remove an appendix as well as a doctor can. This post was really popular on Panda's website because everything he's talking about is an extreme case of something we've all experienced. Patriarchy in medicine is an era long since gone; the new way to practice is by forming a partnership with the patient, informed consent every step of the way -- which is nothing but good, in my opinion. Patients SHOULD know about their healthcare and take ownership of and responsibility for their bodies. Unfortunately, as I learned on my medicine subI, there are no quick fixes for a lifetime of bad habits, and sometimes patients are upset that we can't offer them a surgery or short regimen of pills to "fix" their problems. Like...dude, you're sick. Don't trivialize your own health.

Also, as one of my attendings said, doctors are just too nice! We HAVE to be -- it's part of the hippocratic oath. A lawyer can turn down a case she thinks won't be lucrative. We can't turn away a patient who needs healthcare just because they have their attorney on speed-dial. When I went into medicine, I had no idea that the doctor-patient relationship could be so adversarial. We all want the same things here -- how can we not be on the same team? I just received a 500-page book and some DVDs (along with popcorn, heh) about "risk management" I'm supposed to churn through before residency starts. Ugh. I didn't sign up for this.

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